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The AIDS virus damages the brain in two ways, by not only killing brain cells but by preventing the birth of new cells, U.S. researchers reported on Wednesday.

The study, published in the journal Cell Stem Cell, helps shed light on a condition known as HIV-associated dementia, which can cause confusion, sleep disturbances and memory loss in people infected with the virus.

It is less common in people taking drug cocktails to suppress the virus, and why HIV damages brain function is not clearly understood.

The virus kills brain cells but it also appears to stop progenitor cells, known as stem cells, from dividing, the team at Burnham Institute for Medical Research and the University of California at San Diego found.

"It's a double hit to the brain," researcher Marcus Kaul said in a statement. "The HIV protein both causes brain injury and prevents its repair."

The cocktail of drugs known as highly active antiretroviral therapy or HAART that treats HIV does not infiltrate the brain well, allowing for a "secret reservoir" of virus, said Stuart Lipton, who worked on the study.

HIV-associated dementia is becoming more common, as patients survive into their older years.

Working in mice, the researchers found that the virus directly interferes with the birth of new brain cells from stem cells.

"The breakthrough here is that the AIDS virus prevents stem cells in the brain from dividing; it hangs them up," Lipton said. "It's the first time that the virus has ever been shown to affect stem cells."

The culprit is gp120 -- a protein found on the outside of the AIDS virus, the researchers found.

"Knowing the mechanism, we can start to approach this therapeutically," Lipton said.

"This indicates that we might eventually treat this form of dementia by either ramping up brain repair or protecting the repair mechanism," Kaul added.

Nice to know. I am sure there will another several pills per day to combat this. I have given instructions to my wife,if I start to lose my sanity,if i havent already, to just shoot me or let me drink myself to death.Now we all are gonna start imagining brain problems. Wait a minute,I do have brain problems. I keep making the same mistakes over and over.

On a point of etiquette, you also posted it in this thread in the Mental Health forum which is cross-posting, and discouraged. And posting the whole paper makes the threads kinda long n slow for us dial-up users (there are quite a lot of us here still). I personally find a summary plus a link to the original source more helpful (not least cos you can check the material and it avoids, er, those eternal questions of copyright infringement).

The article doesnt state at which stage of Infection the damage happens. I asked my doc about this and he seems to think this can happen at the leter stages when the cd4 count is lower. Is that correct?

That had sort of been my understanding as well but the new research SEEMS to indicate that some long term survivors are begininng to experience some of the same sorts of symptoms (confusion, memory loss, disorientation, etc). I spoke to my doc as well about it and his response was more or less no one really knows for sure... the virus is so damn smart and tough to clear out of the organs that this may very well be the next hurdle for those of us who have been living with HIV long term. I suppose the question now is what is the real cause of the increased erratic behaviour (for lack of a better term) - is it the disease, the toxic medications we ingest on a daily basis to stay alive, the psychological effects of living with this disease for so long and seeing so many of our loved ones die of it or a combination of some or all of the above? To me, the natural conclusion to a question of that nature would obviously be a combination of all of the above. That being said however, we have to remind ourselves that we already know that this disease and the meds we take to control it often cause serious damage to many of our major organs and as everything being connected it would be absurd not to assume that eventually the effects would begin to damage our brains as well. Obviously we are facing a lot of new questions and problems in successfully treating HIV in the long term. While I am grateful beyond words for the years I have been given thanks to these new drugs at the same time I am fearful of what they are doing to the rest of my body and mind in the long term . At this point it seems like our health status is in a trade off sort of situation... take the meds now and live longer with the knowledge that we are much more likely to die at an earlier age than most from thing like liver diseases and cholesterol clogging our artieries until our hearts explodes due to the side effects of the meds or not do the treatments and hope we are among the lucky few "non-pogressors" in the world. For me I'll stick to the meds but it's a bitch of a choice. I think it's important as people with HIV that we focus on the implications of the long term effects of the meds we take and be aware of how to minimize their effects as well as insist on the investigation and research into more holistic naural medicines that may exist.

Certainly the medications are toxic, and we definitely don't have all the answers. However, with regard to side effects, fortunately, most of us are monitored on a fairly frequent basis for things like cholesterol, liver function, kidney function, etc., and if anything seems out of the ordinary, then there is usually some intervention (a change of medications or some approach to deal with the side effects).

So while side effects are clearly something we should be concerned about and trying to minimize, I don't know if it's really that hopeless. If your cholesterol is rising, any doc worth his/her weight in salt isn't going to say 'well, it's just the meds, we can't do anything about it'...instead he/she would discontinue the responsible med, treat the cholesterol in addition to the HIV or give a referral for a qualified professional who would be able to treat it. The issue is looking at the big picture and managing side effects, sometimes creatively.

Also, it's risky to make future predictions based on what's available today. HIV treatment will likely change very dramatically over the next few decades. 20 years ago, the only thing out there was AZT, given at alarmingly high doses. It would have been unwise to make predictions about medical technology in 2007 back then. Hopefully, in the future, the amount of toxic substances in the future is much less than it is today.

Since some white blood cells are bad for the brain if present in volume, immune activation caused by HIV is probably responsible for some degree of neurological impact from day 1 of infection. Whether this is important is a moot point, and is clearly not the only mechanism affecting brain function long term.

This brain stuff has been bugging me - this new research is very interesting (if disheartening). My question is that if virus is controlled to undetectable or very low by haart, where is the free flowing virus coming from which is impacting the brain, since my understanding is the hiv can't directly infect brain cells (just affect them, as per the article). We konw of course there is some low-level replication in the testes and intestines, but wouldn't there have to be virus replicating in the brain to affect it and if so, shouldn't haart then prevent dementia? Someone else have a grip on this?